Drowning death rates are three to four times lower in states that regulate swimming in oceans, rivers and lakes, a U.S. study suggests. Researchers examined data on so-called open-water drownings for all 50 states from 2012 to 2017. They also looked at regulations in 30 states in 2017 for things like lifeguards, rescue equipment, warning signs, tracking and reporting safety issues, and water quality. States without any such regulations had open-water drowning death rates 3 times higher among children and teens and 4.2 times higher among non-white residents compared with states with regulations covering all five of these things, the study found. “While it seems obvious that requiring some kind of lifeguarding would save some lives, what it means is that the state has committed to lifeguarding with probable funding, education, training,” said lead study author Dr. Linda Quan of Seattle Children’s Hospital and the University of Washington School of Medicine. “It makes real sense to me that the regulation requiring planning and tracking with surveillance, and keeping an eye on the problem means that the state has its finger on the pulse of the problem at some level,” Quan said by email. “In other words, drowning prevention is on the state’s radar; the more attention it gives the problem, the more trickle-down that concern goes.” Open-water areas like lakes, rivers and oceans are the most common sites for drownings among people over age 5, researchers note in Injury Prevention. States and local communities have implemented a wide range of policies to try to minimize drownings, including marking off designated areas for swimming and posting signs advising against swimming when lifeguards aren’t on duty. But research to date hasn’t offered a clear picture of whether legislation regulating open waters impacts drowning rates, the study team notes. For the current study, researchers focused on the relationship between legislation and open-water drowning-death rates in the 20 states with the highest rates and the 10 with the lowest rates. Between 2012 and 2017, 10,839 people drowned in open waters in these 30 states. The highest open-water drowning rates were primarily in northwest and southeast, with the highest rates in Hawaii, Alaska, Idaho and Wyoming. The lowest rates were in Rhode Island, New York and Delaware. Only 12 of the 30 states had regulations for open-water swim sites. Only four – Illinois, New York, West Virginia and New Jersey – had four or five regulations in place. Signage and water quality were not associated with lower open-water drowning rates, but after accounting for influential factors, such as a state’s total water area and poverty, surveillance and planning were each associated with a 45% reduction in drowning rates compared to when those policies were absent. Lifeguards were also associated with a 33% lower drowning rate. The study doesn’t prove whether or how legislation regulating use of open waters directly impacts drowning deaths. “The effectiveness of state safety laws and regulations has been demonstrated for other types of injury, so it is clearly plausible that state safety regulations for open-water areas, including requiring the presence of lifeguards, may lead to decreased drowning,” said Dr. Gary Smith, president of the Child Injury Prevention Alliance in Columbus, Ohio. Learning to swim, not swimming alone and swimming in designated areas where lifeguards are on duty can all help prevent drownings regardless of what regulations might be in place, Smith, who wasn’t involved in the study, said by email. So can being aware of tides, water depth, potential underwater hazards, currents, waves and weather.